St. Barnabas Hospital

All Charges

Charge

Type

Price

CC ACCESS KIT 5F VAS/SOL

Facility OP

$490.00

Hospital Charge Code	66520236
Hospital Revenue Code	481
Min. Negotiated Rate	$171.50
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$245.00
Rate for Payer: Aetna Government	$245.00
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,959.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,215.78
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

CC ACID ICD PREP KIT

Facility OP

$140.78

Hospital Charge Code	66520270
Hospital Revenue Code	480
Min. Negotiated Rate	$49.27
Max. Negotiated Rate	$112.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.39
Rate for Payer: Aetna Government	$70.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.73
Rate for Payer: Group Health Inc Commercial	$70.39
Rate for Payer: Group Health Inc Medicare	$49.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.39
Rate for Payer: Hamaspik Choice Inc Medicare	$70.39

CC ACID PACK

Facility OP

$113.50

Hospital Charge Code	66520254
Hospital Revenue Code	480
Min. Negotiated Rate	$39.72
Max. Negotiated Rate	$90.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.75
Rate for Payer: Aetna Government	$56.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.18
Rate for Payer: Group Health Inc Commercial	$56.75
Rate for Payer: Group Health Inc Medicare	$39.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.75
Rate for Payer: Hamaspik Choice Inc Medicare	$56.75

CC ACTIVATED CLOTTING TIME

Facility OP

$10.70

Service Code	HCPCS 85347
Hospital Charge Code	66521925
Hospital Revenue Code	300
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$6.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.28
Rate for Payer: Aetna Government	$4.28
Rate for Payer: Cash Price	$4.28
Rate for Payer: Cash Price	$4.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.72
Rate for Payer: Elderplan Medicare Advantage	$4.28
Rate for Payer: EmblemHealth Commercial	$4.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.85
Rate for Payer: Fidelis Essential Plan Aliesa	$3.64
Rate for Payer: Fidelis Essential Plan QHP	$3.81
Rate for Payer: Fidelis Medicare Advantage	$4.28
Rate for Payer: Fidelis Qualified Health Plan	$3.81
Rate for Payer: Group Health Inc Commercial	$4.28
Rate for Payer: Group Health Inc Medicare	$4.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.28
Rate for Payer: Healthfirst Medicare Advantage	$4.28
Rate for Payer: Healthfirst QHP	$4.28
Rate for Payer: Senior Whole Health Medicare Advantage	$4.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.42
Rate for Payer: Wellcare Medicare	$3.85

CC ADVANTIO DR IS-1

Facility OP

$11,100.00

Service Code	HCPCS C1785
Hospital Charge Code	66526899
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$11,655.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,105.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,550.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,382.50
Rate for Payer: Fidelis Medicare Advantage	$11,655.00
Rate for Payer: Group Health Inc Commercial	$5,550.00
Rate for Payer: Group Health Inc Medicare	$3,885.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,550.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,215.00

CC ADVANTIO SR IS-1

Facility OP

$10,100.00

Service Code	HCPCS C1786
Hospital Charge Code	66526898
Hospital Revenue Code	275
Min. Negotiated Rate	$1,116.69
Max. Negotiated Rate	$10,605.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,555.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,116.69
Rate for Payer: Aetna Government	$1,116.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,050.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,807.50
Rate for Payer: Fidelis Medicare Advantage	$10,605.00
Rate for Payer: Group Health Inc Commercial	$5,050.00
Rate for Payer: Group Health Inc Medicare	$3,535.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,050.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,565.00

CC AL 11 7F MED LAUNCHER

Facility OP

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66528998
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC AL 11 7F MED LAUNCHER

Facility IP

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66528998
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC AL I (100CM)5F

Facility OP

$44.80

Hospital Charge Code	66528783
Hospital Revenue Code	480
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$35.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.40
Rate for Payer: Aetna Government	$22.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.46
Rate for Payer: Group Health Inc Commercial	$22.40
Rate for Payer: Group Health Inc Medicare	$15.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.40
Rate for Payer: Hamaspik Choice Inc Medicare	$22.40

CC ALTRUA 60 DDDR IS-1 (EL)

Facility OP

$5,500.00

Service Code	HCPCS C1785
Hospital Charge Code	66526871
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$5,775.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,025.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,162.50
Rate for Payer: Fidelis Medicare Advantage	$5,775.00
Rate for Payer: Group Health Inc Commercial	$2,750.00
Rate for Payer: Group Health Inc Medicare	$1,925.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,575.00

CC AMPLATZ SUPER STIFF .035X180CM

Facility OP

$83.07

Hospital Charge Code	66528317
Hospital Revenue Code	480
Min. Negotiated Rate	$29.07
Max. Negotiated Rate	$66.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.54
Rate for Payer: Aetna Government	$41.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.49
Rate for Payer: Group Health Inc Commercial	$41.54
Rate for Payer: Group Health Inc Medicare	$29.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.54
Rate for Payer: Hamaspik Choice Inc Medicare	$41.54

CC AMPLATZ SUPERSTIFF 0.38/180CM

Facility OP

$59.38

Hospital Charge Code	66528407
Hospital Revenue Code	480
Min. Negotiated Rate	$20.78
Max. Negotiated Rate	$47.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.69
Rate for Payer: Aetna Government	$29.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.38
Rate for Payer: Group Health Inc Commercial	$29.69
Rate for Payer: Group Health Inc Medicare	$20.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.69
Rate for Payer: Hamaspik Choice Inc Medicare	$29.69

CC AMP. SUPERSTIFF .035/260CM JTP

Facility OP

$83.07

Hospital Charge Code	66528318
Hospital Revenue Code	480
Min. Negotiated Rate	$29.07
Max. Negotiated Rate	$66.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.54
Rate for Payer: Aetna Government	$41.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.49
Rate for Payer: Group Health Inc Commercial	$41.54
Rate for Payer: Group Health Inc Medicare	$29.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.54
Rate for Payer: Hamaspik Choice Inc Medicare	$41.54

CC ANGIOGRAPHIC CONTROL SYRINGE

Facility OP

$8.00

Hospital Charge Code	66528404
Hospital Revenue Code	270
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00

CC ANGIO KIT LEFT HEART KIT BOSTO

Facility OP

$59.04

Hospital Charge Code	66528410
Hospital Revenue Code	270
Min. Negotiated Rate	$20.66
Max. Negotiated Rate	$47.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.52
Rate for Payer: Aetna Government	$29.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.15
Rate for Payer: Group Health Inc Commercial	$29.52
Rate for Payer: Group Health Inc Medicare	$20.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.52
Rate for Payer: Hamaspik Choice Inc Medicare	$29.52

CC ANGIO-SEAL STS PLUS 6F ST. JUD

Facility OP

$490.00

Hospital Charge Code	66528403
Hospital Revenue Code	270
Min. Negotiated Rate	$171.50
Max. Negotiated Rate	$392.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$245.00
Rate for Payer: Aetna Government	$245.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$392.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$333.20
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

CC AORTA, ABDOMNL + BILAT ILIOFEM

Facility OP

$8,393.53

Service Code	HCPCS 75630 TC
Hospital Charge Code	66528248
Hospital Revenue Code	320
Min. Negotiated Rate	$71.68
Max. Negotiated Rate	$6,714.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,714.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,707.60
Rate for Payer: Fidelis CHP/HARP/Medicaid	$71.68
Rate for Payer: Group Health Inc Commercial	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$79.64

CC AR I (100CM)5F

Facility OP

$44.80

Hospital Charge Code	66528788
Hospital Revenue Code	480
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$35.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.40
Rate for Payer: Aetna Government	$22.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.46
Rate for Payer: Group Health Inc Commercial	$22.40
Rate for Payer: Group Health Inc Medicare	$15.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.40
Rate for Payer: Hamaspik Choice Inc Medicare	$22.40

CC AR I MOD (100CM)5F

Facility OP

$44.80

Hospital Charge Code	66528789
Hospital Revenue Code	480
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$35.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.40
Rate for Payer: Aetna Government	$22.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.46
Rate for Payer: Group Health Inc Commercial	$22.40
Rate for Payer: Group Health Inc Medicare	$15.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.40
Rate for Payer: Hamaspik Choice Inc Medicare	$22.40

CC ARROW 6FR SUPER ARROWFLEX 45CM

Facility OP

$130.00

Hospital Charge Code	66529919
Hospital Revenue Code	480
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$104.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.00
Rate for Payer: Aetna Government	$65.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.40
Rate for Payer: Group Health Inc Commercial	$65.00
Rate for Payer: Group Health Inc Medicare	$45.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.00
Rate for Payer: Hamaspik Choice Inc Medicare	$65.00

CC ASSURITY PACEMAKER

Facility OP

$16,987.50

Service Code	HCPCS C1785
Hospital Charge Code	66571568
Hospital Revenue Code	278
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$17,836.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,343.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,493.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,767.81
Rate for Payer: Fidelis Medicare Advantage	$17,836.88
Rate for Payer: Group Health Inc Commercial	$8,493.75
Rate for Payer: Group Health Inc Medicare	$5,945.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,493.75
Rate for Payer: Hamaspik Choice Inc Medicare	$8,493.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,041.88

CC ASSURITY PACEMAKER

Facility IP

$16,987.50

Service Code	HCPCS C1785
Hospital Charge Code	66571568
Hospital Revenue Code	278
Min. Negotiated Rate	$8,493.75
Max. Negotiated Rate	$8,493.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,493.75
Rate for Payer: Hamaspik Choice Inc Medicare	$8,493.75

CC BAIR HUGGER (TEMP MGMT BLANKET

Facility OP

$53.00

Hospital Charge Code	66526855
Hospital Revenue Code	270
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$42.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.50
Rate for Payer: Aetna Government	$26.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.04
Rate for Payer: Group Health Inc Commercial	$26.50
Rate for Payer: Group Health Inc Medicare	$18.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.50
Rate for Payer: Hamaspik Choice Inc Medicare	$26.50

CC BAND HEMOSTAT D-STAT RADIAL

Facility OP

$1,180.00

Hospital Charge Code	66520237
Hospital Revenue Code	481
Min. Negotiated Rate	$413.00
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$649.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$590.00
Rate for Payer: Aetna Government	$590.00
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,959.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,215.78
Rate for Payer: Group Health Inc Commercial	$590.00
Rate for Payer: Group Health Inc Medicare	$413.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$590.00
Rate for Payer: Hamaspik Choice Inc Medicare	$590.00

CC BAND TR RAD COMP DEV 24CM REG

Facility OP

$395.00

Hospital Charge Code	66520205
Hospital Revenue Code	270
Min. Negotiated Rate	$138.25
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$217.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$197.50
Rate for Payer: Aetna Government	$197.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$316.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$268.60
Rate for Payer: Group Health Inc Commercial	$197.50
Rate for Payer: Group Health Inc Medicare	$138.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$197.50
Rate for Payer: Hamaspik Choice Inc Medicare	$197.50

Price Transparency.

All Charges